The Journal of Clinical Endocrinology & Metabolism, jc., 2019; 104(6): 2250-2256, PMID: 30715368

Glucocorticoids and body fat inversely associate with bone marrow density of the distal radius in healthy youths

Year: 2019

Jonas Esche Lijie Shi Michaela F Hartmann Eckhard Schönau Stefan A Wudy Thomas Remer

Abstract

Background
Elevated bone marrow adipose tissue (BMAT) is associated with lower bone quality, higher fracture rates, and an unfavorable overall metabolic profile. Apart from older age, particularly glucocorticoids (GC), body fat, and diet are discussed to influence BMAT. Against this background, we hypothesized that already in healthy children and adolescents higher dietary fat intake, higher fat mass index (FMI), and higher GC-secretion, still within the normal range, may associate with increased BMAT.
Methods
In a subsample of healthy 6-18 year-old participants of the DONALD study, peripheral quantitative computed tomography (pQCT) of the nondominant proximal forearm was used to determine bone marrow density of the distal radius as an inverse surrogate parameter for BMAT. In those participants (n=172), who had collected two 24-h urines, one a year before and one around the time of bone-measurement, major urinary GC-metabolites were measured by gas chromatography-mass spectrometry and summed up to assess daily adrenal GC-secretion (?C21). Dietary intake was assessed by 3-day weighed dietary records. FMI was anthropometrically calculated. Separate multiple linear regression models were used to analyze the relationship of ?C21, FMI as well as carbohydrate- and fat-intake with BMAT.
Results
After controlling for confounders, such as age, energy intake, and forearm muscle area, both ?C21 (ß=-0.042) and FMI (ß=-0.002) showed inverse relationships with bone marrow density (p<0.05), whereas carbohydrate- and fat-intake did not associate significantly.
Conclusion
Our results indicate that already a moderately elevated GC-secretion and higher body fatness during adolescence may adversely impact on BMAT, an indicator for long-term bone health.

GID: 4841; Last update: 05.02.2019